Supreme Court to decide how pro-life pregnancy centers can counsel patients

Informed Choices is what its president describes as a "life-affirming" pregnancy center on the edge of downtown Gilroy in northern California.

Even as it advertises "free pregnancy services" and promises in signs on its door and inside to discuss all options with pregnant women, Informed Choices exists to steer women away from abortion.

The state of California, prompted by abortion rights groups, worried that vulnerable, uninsured women were going to Informed Choices and other anti-abortion crisis pregnancy centers expecting they would get comprehensive care. That prompted passage of a new law requiring crisis pregnancy centers that are licensed by the state to let their clients know that abortions and other medical services are available elsewhere, for little or no cost. It also requires unlicensed facilities to post signs disclosing they are unlicensed.

That law has led to a Supreme Court fight at the intersection of abortion and free speech. Christine Vatuone, the president of Informed Choices, said that posting such a sign in her licensed center's waiting room or handing information to a client would force Informed Choices to act as "a billboard for the abortion industry."

The court is hearing the case Tuesday. While justices won't be dealing with broader questions about the right to an abortion, the outcome could affect not only California's law, but those in other states that have been shaped by anti-abortion groups. Some states, for example, require doctors to display a sonogram and describe the fetus to women considering an abortion.

California's law was challenged by the National Institute of Family and Life Advocates (NIFLA), an organization with ties to 1,500 pregnancy centers nationwide and 140 in California, including Informed Choices.

Anne O'Connor, NIFLA's vice president of legal affairs, said the centers exist to promote childbirth.

"The crux of this issue is, can the government force anybody ... to advertise for a message that they're morally opposed to. We feel strongly that it violates our First Amendment rights," Ms. O'Connor said in an interview in the Washington offices of Alliance Defending Freedom, the Christian law firm representing NIFLA at the Supreme Court.

The Trump administration agrees with NIFLA that the law violates the rights of licensed centers, but, unlike NIFLA, has no objection to the requirement for the unlicensed centers.

California argues that it is not stepping on speech rights by requiring the centers to provide what it calls a neutral statement of fact about health care options for pregnant women.

For the abortion rights organizations, the information is a matter of protecting vulnerable women who may not know that the state offers family planning, abortion care, and pre-natal services. The groups have complained for years that the centers mislead women and pressure them not to have abortions.

Crisis pregnancy centers are "fake women's health centers" that try to look like clinics that offer abortion and birth control, even choosing names like Informed Choices to muddy the waters, said Amy Everitt, the California director of NARAL Pro-Choice Amerca.

"But they only have one option, to carry a pregnancy to term. And they have one agenda, to stop women from accessing abortion care and birth control," Ms. Everitt said in her office in San Francisco.

Estimates of the number of crisis pregnancy centers run from 2,500 to more than 4,000, compared with fewer than 1,500 abortion providers, women's rights groups said in a Supreme Court filing.

Crisis pregnancy centers were recently in the news as part of a lawsuit over abortion access for a pregnant immigrant teenager in federal custody. Emails disclosed as part of the lawsuit showed that the Trump administration official who oversees the shelters where immigrant teens are held instructed employees to direct pregnant teens to anti-abortion counseling at crisis pregnancy centers.

A pregnant woman who walked in off the street to the Informed Choices office might think she was entering a typical women's health clinic. Inside, an examination room has a new ultrasound machine. Clients are given standard medical privacy forms.

Ms. Vatuone, the Informed Choices president and CEO, disputed that women can be misled by what her center offers. If anything, more often the women who come in think abortion is their only choice. The center has been seeing roughly 50 women a month recently, a significant increase since it was licensed by the state early in 2017 to do ultrasound exams, she said.

"We feel really proud of the fact that we can talk about all the options," Vatuone said.

Vatuone said it's a myth that "every girl we see is a 16-year-old in a crisis pregnancy. The average age is in the 20s. Some are very excited. Others are scared to death. These women are lacking some kind of support and that's why they end up here."

Informed Choices keeps a room stocked with donated baby clothing and supplies for new mothers.

Vatuone acknowledged that people who come to see her sometimes have abortions. Still, she said, "We've had great relationships with women who did choose an outcome we wouldn't necessarily want her to choose."

Women's groups in support of the law said that health care for women who first go to crisis pregnancy centers sometimes can be delayed. In some cases, they said, women have been unable to obtain less invasive medication abortions, which typically are available in the first 10 weeks of pregnancy. In others, crisis pregnancy centers missed serious health complications, including an ectopic pregnancy in which a fertilized egg attaches itself somewhere other than in a woman's uterus.

This story was reported by The Associated Press.